Treatment for advanced womb cancer ‘major step forward'
The treatment, pembrolizumab, can slow down cancer growth and improve survival odds, health officials said.
The National Institute for Health and Care Excellence (Nice) estimates that around 2,100 women will benefit from the treatment each year.
It said that its approval of the treatment for the NHS in England marks a 'major step forward' in treatment for women with this type of cancer.
The treatment, also known as Keytruda and made by Merck Sharp and Dohme, is an immunotherapy drug and is delivered in a drip alongside chemotherapy drugs carboplatin and paclitaxel and can be given for up to two years.
Nice said that clinical trials show the combination of treatments reduced the risk of death by 26% compared to chemotherapy alone.
The treatments can also slow down cancer progression, it added.
'For people with advanced endometrial cancer, this innovative combination offers a powerful new treatment option,' said Helen Knight, director of medicines evaluation at Nice.
'It marks a major step forward, and we're pleased to recommend it as part of our commitment to getting the best care to people, fast, while ensuring value for the taxpayer.'
Around 9,700 women are diagnosed with endometrial cancer each year, Nice said, making it the most common gynaecological cancer in the UK.
Helen Hyndman, lead nurse at the charity Eve Appeal's information service Ask Eve, said: 'Primary advanced or recurrent womb (endometrial) cancer has a huge impact on the quality of life for those diagnosed.
'It is great news that this new treatment has been approved.
'It will offer hope, a better quality of life and improve outcomes for those affected.'
Professor Peter Johnson, NHS England's national clinical director for cancer, said: 'Getting this treatment to many more NHS patients as quickly as possible will help thousands of women live longer, allowing them to spend more time with loved ones and give them a better quality of life.
'Thanks to the NHS's Cancer Drugs Fund, it is now being fast-tracked into routine use, with treatment available to more patients from today.'
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Originally created for NHS patients at his practice in Somerset, the results were so positive, the programme has been made freely available online. 'The GLP-1 boom has at least put metabolic health on the radar,' says Dr Murdoch. 'Now we need to give people complete solutions, including lifestyle, not just the drugs.' Here are the three diets doctors recommend. Low-carb diet Key benefits: simple and sustainable The low-carb diet is proven to get results and can curb food cravings, reverse type 2 diabetes and deliver comparable weight loss to GLP-1s, suggests latest research. Cutting down on sugar and starchy carbs deprives the body of its primary fuel, glucose. It starts burning body fat instead, leading to weight loss. Blood-sugar levels stabilise, appetite regulates, and insulin levels fall, leading to better metabolic health and lower risk of type 2 diabetes and cardiovascular disease. 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People can lose several pounds in the first week, gradually slowing to a more sustainable rate. Dr Westman's clinical research has shown that a keto diet can put type 2 diabetes into remission. Around 98 per cent of his patients with type 2 diabetes come off insulin. 'Patients typically lose one to two pounds a week,' he says. 'I can safely de-prescribe medications for diabetes, hypertension, heartburn and arthritis.' A meta-analysis of trials, in Nutrients, found that ketogenic diets gave better weight loss and blood-sugar control than a low-carb diet. Sharon Grey, 56, was almost 18st and living with type 2 diabetes, Nash (non-alcoholic fatty liver disease), high blood pressure and depression before she began Dr Westman's keto programme ( After 13 months, her weight had dropped to 12st 8lb. 'I reversed my type 2 diabetes and Nash, and my blood pressure is normal again,' she says. 'My headaches, backache and knee pain improved, my mood is better and I'm taking fewer medications.' The key to keto success is to keep carbs under 50g a day. Include plenty of protein, says Dr Westman. 'Protein is critical as it helps you feel full, and ensures you lose fat, not muscle,' he says. 'Don't overdo the dietary fat - if you eat too much of it, your body will burn that, rather than body fat.' His top five keto foods are eggs, meat or poultry, seafood, non-starchy veg (like cauliflower or broccoli) and leafy greens. So when should you choose keto, rather than a low-carb diet? 'Keto isn't always necessary, but in severe cases, it can be beneficial,' says Dr Murdoch. 'The keto diet offers rapid results and some patients feel better on it,' adds Dr Unwin. 'However, it's more complicated than a standard, low-carb diet, and not essential for reversing type 2 diabetes.' Transitioning to ketosis can trigger temporary fatigue and nausea, called 'keto flu'. If you're on medication, or have a medical condition, only try keto under medical supervision, advises Dr Westman. Intermittent fasting Key benefits: cheap and effective If you don't like calorie counting, focusing on when you eat, rather than what you eat, could be the solution. Intermittent fasting – alternating periods of eating and fasting, such as the popular 5:2 diet – can lead to an average weight loss of five to nine per cent of body weight over three to 12 months, according to research. 'When we don't eat, the body moves into fat-release mode,' explains Dr Murdoch. 'Fasting gives the body longer to use up stored sugar and burn body fat. That's why it improves blood-sugar control, too.' Among the most effective fasting methods is time-restricted eating (TRE), where you consume your food within a defined window each day, followed by an overnight fast. A study at Manchester Metropolitan University found that just three days on the 16:8 method (eating within an eight-hour window and fasting for 16 hours) significantly improved blood-sugar control in people with type 2 diabetes. 'TRE offers promising benefits for weight loss, glucose regulation and metabolic health – without calorie counting,' says study lead Dr Kelly Bowden Davies. 'While average weight loss is typically less than with GLP-1 drugs, prolonged use of TRE is a cheaper, safer and more accessible alternative – especially when combined with lifestyle changes.' That's the approach taken by Dr Murdoch with his Metabolic Health 28-Day Plan. It combines time-restricted eating (11am-7pm), focusing on lower-carb (often under 70g a day), high-protein (1-2g per kilo of body weight a day) foods, daily movement (for example, squats while the kettle boils) and seven hours' sleep, presented as a tick list of 10 daily habits. 'People often lose half a stone to a stone in the first month,' says Dr Murdoch. 'Blood pressure, blood sugar, mood and energy all improve. It's as effective as GLP-1s, for a fraction of the cost, and with far better sustainability.' Donna Brewer, 48, weighed nearly 22st when she started the plan in April. 'I'd gradually gone from a size 14 to a 24. I felt sluggish, tired, anxious, and my blood pressure was dangerously high,' she says. 'After 28 days, I'd lost almost one-and-a-half stone. Now I'm down more than 2st, my waist's shrunk from 130cm to 118cm, and I'm off medication. I feel so much happier and more energetic. It's not like a diet – more a shift in mindset.' The health risks of GLP-1s Using GLP-1 drugs without nutrition advice or lifestyle support can lead to malnutrition and even accelerated ageing, caution experts. 'GLP-1s reduce appetite but if you simply eat less of a regular, poor diet, you risk becoming deficient in protein and nutrients – and this drives muscle loss,' says Dr Murdoch. 'We're already seeing muscle loss and then weight regain when people stop taking the drugs.' An Oxford University review found that most people regain the weight within 10 months of stopping GPL-1s. 'The drugs are only licensed for two years [and many patients give up earlier],' says Dr Murdoch. 'After that, if you haven't changed your habits, the weight comes back – and you've lost muscle along the way, which is hard to get back.' In a recent clinical trial, 42 per cent of over-60s lost at least 10 per cent of their muscle power – the equivalent of ageing 7.5 years – within six months of taking the GLP-1 drug semaglutide. 'You need to pair these drugs with resistance training and proper nutrition, particularly protein,' says Dr Murdoch. GLP-1s do have a role to play, say the doctors. 'For people addicted to ultra-processed food or who struggle to give up starchy carbs, GLP-1s can be a temporary tool, if combined with nutritional support,' says Dr Unwin. 'I recently had a 75-year-old patient who lost a stone and a half and came off insulin by combining a GLP-1 with a low-carb diet.' However, he and other doctors are concerned the drugs are being promoted as a fix-all. 'The way weight-loss drugs are being pushed as a default solution is worrying,' says Dr David Jehring, chairman of the PHC, chief executive of Black Pear Software and creator of Elevate, a new AI personal health coach, soon to be trialled in the NHS. ' GLP-1s are now so widely available, primary care services are being told they don't need to offer dietary interventions.'
